Texas 2019 - 86th Regular

Texas House Bill HB1410 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~86R24953~~ SMT-F
	1	+	86R7093 SMT-F
2	2		By: Lucio III H.B. No. 1410
3		-	Substitute the following for H.B. No. 1410:
4		-	By: Lucio III C.S.H.B. No. 1410
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to payment for care provided by a chiropractor under
10	8		certain health benefit plans.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	10		SECTION 1. Subchapter I, Chapter 843, Insurance Code, is
13	11		amended by adding Section 843.3042 to read as follows:
14	12		Sec. 843.3042. CHIROPRACTIC SERVICES. (a) A health
15	13		maintenance organization offering a health care plan that covers a
16		-	service that is within the scope of the practice of chiropractic as
17		-	described by Section 201.002, Occupations Code, may not refuse to
18		-	provide reimbursement to an in-network chiropractor for the
19		-	performance of the covered service solely because the service is
20		-	provided by a chiropractor.
	14	+	service that is within the scope of a chiropractor's license may not
	15	+	refuse to provide reimbursement for the performance of the covered
	16	+	service solely because the service is provided by a chiropractor.
21	17		(b) This section does not require a health maintenance
22	18		organization to cover a particular health care service.
23	19		(c) This section does not affect the right of a health
24	20		maintenance organization to determine whether a health care service
25	21		is medically necessary.
	22	+	(d) A chiropractor may file an action against a health
	23	+	maintenance organization to recover payment for a covered service
	24	+	provided by the chiropractor within the scope of the chiropractor's
	25	+	license and may recover reasonable attorney's fees and court costs
	26	+	if the chiropractor prevails in the action.
26	27		SECTION 2. Subchapter B, Chapter 1301, Insurance Code, is
27	28		amended by adding Section 1301.0516 to read as follows:
28	29		Sec. 1301.0516. CHIROPRACTIC SERVICES. (a) An insurer
29		-	offering a preferred provider benefit plan, other than an exclusive
30		-	provider benefit plan, that covers a service that is within the
31		-	scope of the practice of chiropractic as described by Section
32		-	201.002, Occupations Code, may not refuse to provide reimbursement
33		-	for the performance of the covered service solely because the
34		-	service is provided by a chiropractor.
35		-	(b) An insurer offering an exclusive provider benefit plan
36		-	that covers a service that is within the scope of the practice of
37		-	chiropractic as described by Section 201.002, Occupations Code, may
38		-	not refuse to provide reimbursement to a chiropractor who is a
39		-	preferred provider for the performance of the covered service
	30	+	offering a preferred provider benefit plan that covers a service
	31	+	that is within the scope of a chiropractor's license may not refuse
	32	+	to provide reimbursement for the performance of the covered service
40	33		solely because the service is provided by a chiropractor.
41		-	(c) This section does not require an insurer to cover a
	34	+	(b) This section does not require an insurer to cover a
42	35		particular medical or health care service.
43		-	(d) This section does not affect the right of an insurer to
	36	+	(c) This section does not affect the right of an insurer to
44	37		determine whether a medical or health care service is medically
45	38		necessary.
46		-	SECTION 3. The change in law made by this Act applies only
	39	+	(d) A chiropractor may file an action against an insurer to
	40	+	recover payment for a covered service provided by the chiropractor
	41	+	within the scope of the chiropractor's license and may recover
	42	+	reasonable attorney's fees and court costs if the chiropractor
	43	+	prevails in the action.
	44	+	SECTION 3. Section 1451.109, Insurance Code, is amended by
	45	+	adding Subsection (e) to read as follows:
	46	+	(e) A chiropractor may file an action against an insurer to
	47	+	recover payment for a covered service provided by the chiropractor
	48	+	within the scope of the chiropractor's license and may recover
	49	+	reasonable attorney's fees and court costs if the chiropractor
	50	+	prevails in the action.
	51	+	SECTION 4. The change in law made by this Act applies only
47	52		to a health benefit plan that is delivered, issued for delivery, or
48	53		renewed on or after January 1, 2020. A health benefit plan that is
49	54		delivered, issued for delivery, or renewed before January 1, 2020,
50	55		is governed by the law as it existed immediately before the
51	56		effective date of this Act, and that law is continued in effect for
52	57		that purpose.
53		-	SECTION 4. This Act takes effect September 1, 2019.
	58	+	SECTION 5. This Act takes effect September 1, 2019.